With support from the Rockefeller Foundation, an international group of experts in public health, animal health, virology, medicine, public policy, economics, bioethics, law and human rights met in Bellagio, Italy from 24 to 28 July 2006 to consider questions of social justice and the threat of avian and human pandemic influenza, with a particular remit to focus on the needs and interests of the world’s disadvantaged.

Although it is generally recognized that the next influenza pandemic could have far-reaching consequences in terms of morbidity and mortality, comparatively little attention has been paid to the ways in which a pandemic could have a disproportionately negative impact on socially and economically disadvantaged groups. As an example, even before a pandemic occurs, poultry farmers, are currently bearing a large part of the burden of efforts to contain the spread of highly pathogenic avian influenza in domestic birds.

The last severe influenza pandemic, which occurred in 1918, resulted in particularly high mortality rates in developing countries, as well as among the poor in developed countries, such as the United States. These and other considerations suggest there is a particular need to address the needs and interests of the world’s disadvantaged while preparing for, and responding to, the threat of an influenza pandemic.